Análise da variabilidade da marcha de indivíduos com comprometimento articular unilateral do quadril por meio de sensores inerciais

Data variability analysis has been the focus of a number of studies seeking to capture differences of patterns generated by biological systems. Although several studies related to gait employ the analysis of variability in their observations, we noticed a lack of such information for subjects with unilateral coxarthrosis undergoing total hip arthroplasty (THA). To tackle this deficiency of information, we conducted a study of the gait on a treadmill with10 healthy subjects (30.7 ± 6.75 years old) from G1 and 24 subjects (65 ± 8.5 years old) with unilateral THA from G2. Thus, by means of two inertial measurement units (IMUs) positioned in the pelvis, we have developed a detection method of the step and stride for calculating these intervals and extract the signal characteristics. The variability analysis (coefficient of variation) was performed, taking into consideration the extracted features and the step and stride times. The average and the 95% confidence interval estimate for the average of the step and stride times to each group were in agreement with literature. The mean coefficient of variation for the step and stride times was calculated and compared among groups by the Kruskal-Wallis test with 95% confidence interval. Each component X, Y and Z of the two IMUs (accelerometer, magnetometer and gyroscope) corresponded to a variable. The resultants of each sensor, the linear velocity (accelerometers) and the instantaneous angular displacement (gyroscopes) completed the set of variables. The characteristics were extracted from the signals of these variables to check the variability in the G1 and G2 groups . There were significant differences (p <0.05) between G1 and G2 for the average of the step and stride times. The variability of the step and stride, as well as the variability of all other evaluated characteristics were higher for the group G2 (p <0.05). The method proposed in this study proved to be suitable for the measuring of variability of biomechanical parameters related to the extracted features. All the extracted features categorized the groups. The G2 group showed greater variability, so it is possible that the age and the pathological condition of the hip both contributed to this result.

Avaliação comparativa da remodelação óssea periimplantar em implantes com junção cone-morse e hexágono externo: estudo clínico randomizado controlado, duplo cego, boca dividida

Background: Several theories, such as the biological width formation, the inflammatory reactions due to the implant-abutment microgap contamination, and the periimplant stress/strain concentration causing bone microdamage accumulation, have been suggested to explain early periimplant bone loss. However, it is yet not well understood to which extent the implant-abutment connection type may influence the remodeling process around dental implants. Aim: to evaluate clinical, bacteriological, and biomechanical parameters related to periimplant bone loss at the crestal region, comparing external hexagon (EH) and Morse-taper (MT) connections. Materials and methods: Twelve patients with totally edentulous mandibles received four custom made Ø 3.8 x 13 mm implants in the interforaminal region of the mandible, with the same design, but different prosthetic connections (two of them EH or MT, randomly placed based on a split-mouth design), and a immediate implant- supported prosthesis. Clinical parameters (periimplant probing pocket depth, modified gingival index and mucosal thickness) were evaluated at 6 sites around the implants, at a 12 month follow-up. The distance from the top of the implant to the first bone-to-implant contact – IT-FBIC was evaluated on standardized digital peri-apical radiographs acquired at 1, 3, 6 and 12 months follow-up. Samples of the subgingival microbiota were collected 1, 3 and 6 months after implant loading. DNA were extracted and used for the quantification of Tanerella forsythia, Porphyromonas gingivalis, Aggragatibacter actinomycetemcomitans, Prevotella intermedia and Fusobacterium nucleatum. Comparison among multiple periods of observation were performed using repeated-measures Analysis of Variance (ANOVA), followed by a Tukey post-hoc test, while two-period based comparisons were made using paired t- test. Further, 36 computer-tomographic based finite element (FE) models were accomplished, simulating each patient in 3 loading conditions. The results for the peak EQV strain in periimplant bone were interpreted by means of a general linear model (ANOVA). Results: The variation in periimplant bone loss assessed by means of radiographs was significantly different between the connection types (P<0.001). Mean IT-FBIC was 1.17±0.44 mm for EH, and 0.17±0.54 mm for MT, considering all evaluated time periods. All clinical parameters presented not significant differences. No significant microbiological differences could be observed between both connection types. Most of the collected samples had very few pathogens, meaning that these regions were healthy from a microbiological point of view. In FE analysis, a significantly higher peak of EQV strain (P=0.005) was found for EH (mean 3438.65 µ∑) compared to MT (mean 840.98 µ∑) connection. Conclusions: Varying implant-abutment connection type will result in diverse periimplant bone remodeling, regardless of clinical and microbiological conditions. This fact is more likely attributed to the singular loading transmission through different implant-abutment connections to the periimplant bone. The present findings suggest that Morse-taper connection is more efficient to prevent periimplant bone loss, compared to an external hexagon connection.